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Nir Sorkin, Michaella Goldstein, Adiel Barak, Elad Moisseiev, Anat Loewenstein; Dexamethasone Intravitreal Implant (Ozurdex®) in Treatment of Refractory Macular Edema. Invest. Ophthalmol. Vis. Sci. 2012;53(14):903.
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To report our experience with dexamethasone 0.7 mg sustained-release intravitreal implant (Ozurdex®; Allergan, Inc, Irvine, CA) in the treatment of refractory cystoid macular edema (CME).
A consecutive clinical series follow-up of patients with refractory CME, treated in our clinic between August 2010 and October 2011, using a sustained-release dexamethasone 0.7 mg intravitreal implant (Ozurdex®). All patients were previously treated (by one or more of: focal/grid laser, anti-VEGF injections, Triamcinolone). Follow-up included a complete ophthalmic examination including visual acuity, intraocular pressure measurements and a funduscopic evaluation, supplemented by Optical Coherence Tomography (OCT), and fluorescein angiography as necessary.
Twenty two eyes of 20 patients were treated with a total of 29 Ozurdex® injections. Fifteen of the 22 eyes had completed a follow-up period of ≥15 weeks, and are included in this report (15 eyes, 13 patients, 18 injections). Mean follow-up time was 19.2 weeks (range 15-26 weeks). The mean baseline Central Macular Thickness (CMT) was 592μ (331-846μ). Fifteen of the 18 implant injections achieved a decrease in CMT of more than 100 micron at any point throughout the follow-up. The mean logMAR baseline BCVA was 0.64. Ten of the 18 implant injections led to an improvement in logMAR BCVA of 0.1 or more throughout the follow-up. Throughout the entire follow-up period, 3 measurements of intraocular pressure (IOP) above 25 mmHg were recorded in 2 patients (range 27-30 mmHg), normalized under topical medications. No adverse post-injection effects were documented.
Intravitreal injection of the Ozurdex® implant should be considered as a treatment option in patients with CME. Its effect on CMT and VA appears to be maximal 9-10 weeks after injection. The treatment safety profile was excellent.
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